The research objective is to study the management of children with cancer by tertiary care center-based pediatric hematologists and private practitioners who are systematically utilizing communication and record-keeping support services. This shared management system of health care delivery is being compared with the standard practice of having all diagnostic and therapeutic measures for these patients provided by hospital-based hematologists. Examination is being made of the outcome of patients managed by hematologists and private practitioners and of patients managed solely by hematologists. Of particular interest is the incidence of fever, infection, drug toxicity, neutropenia, deviation from chemotherapy treatment plan and the number of hospitalizations in the two groups. Additional longitudinal studies of school attendance, educational achievement, school and home behavioral problems, intelligence, and emotional stability are being carried out. The design also includes examination of the time and monetary resources consumed by rural pediatric cancer patients. Cost analyses are being made of the support services required by the shared management system of delivering medical care. Stability of referral patterns for pediatric cancer patients prior to and during the project (1970-1979) is being investigated.